Huge protests are taking place across Poland in response to new ruling hit part of the abortion law of 1993 – which effectively amounts to a legal ban in a country that has already taken a very restrictive approach to abortion.
Abortion was previously authorized for three reasons. The Constitutional Court ruled that the provision allowing abortion in cases of severe fetal abnormality is unconstitutional and is therefore prohibited. Other legal grounds for abortion in Poland are when the pregnancy threatens life or health or when the pregnancy is the result of rape.
Over the past three years, as part of my research into medical abortion and changing models of abortion access, I have interviewed many pro-choice activists in Poland and the countries to which they travel. Polish abortion seekers. What they told me reveals the grim realities of abortion in Poland today as well as the mobilized and energetic cross-border networks of activists ready to fight back.
This court ruling removes the grounds on which the vast majority of abortions take place in Poland. In 2017, Polish government data reported that 1,035 of the 1,057 abortions (97.9%) that occurred were due to a serious fetal abnormality. The proportion of abortions performed in this field has steadily increased every year since 1994: while abortions to preserve life or health represented 88.1% of all legal abortions in 1994, by 2017, they had fallen. at 2.1%.
Meanwhile, rape abortion is now a rarity in Poland. In 2017, not a single termination for these reasons was granted, in a country of 38 million inhabitants. Abortion due to severe fetal abnormality was, in fact, the only way to obtain a legal abortion in the Polish medical system.
Getting an abortion
Getting a legal abortion in Poland has already taken weeks or months due to administrative barriers and obstructive doctor opposition, and those delays will be exacerbated by the new ruling.
In parts of eastern Poland it is effectively impossible obtain an abortion because all medical establishments have declared themselves conscientious objectors to abortion. In other regions, lawyers report this anti-abortion doctors deliberately delay patients, mislead them about their legal right to abortion, or tell them that such procedures are not available in their area.
Pro-choice lawyers are advising patients on how to prepare for such doctors, even suggesting they get stamped proof that hospitals have received their abortion requests. Otherwise, these documents may “disappear” and hospitals may claim to have received – and refused – any abortion requests.
The process of getting a legal abortion can be so exhausting that lawyers find that Polish abortion seekers who are turned down by hospitals often choose not to take legal action. Instead, many travel abroad, search for an illegal provider in Poland, or continue with their pregnancy.
Poland’s restrictive abortion laws, like all of these laws, do not reduce the demand for abortion or the overall number of abortions. In fact, Polish laws serve to create a huge demand for self-administered abortion with pills and abortion travel to other countries.
There is a huge gap between abortions that take place in the formal medical sector – approved by doctors, performed in hospitals – and the large number of clandestine or informal abortions that take place in Poland. Even the recognition of these clandestine abortions is politically contested: while the UN considers between 80,000 and 180,000 abortions per year, the Polish government claims that this number is less than 10,000.
Abortions that take place in underground settings are not technically illegal because Polish law does not make it a crime to terminate your own pregnancy. But that makes it a crime for anyone – doctor, spouse, friend, relative – to help another person terminate a pregnancy, including helping them travel abroad to have an abortion.
By pill or plane
Self-administered abortion with pills is on the increase, according to Polish activists who provide information on how to find and take abortion pills. These activists observe growing demand for pills based on the number of people who contact them looking for information. The secretive nature of self-administered abortion means that no precise data can be collected on the demand or use of abortion pills nationwide.
The medical “underground” still exists in Poland, where doctors perform abortions for money in private clinics or home offices, but doctors performing this type of abortion are less every year. Activists who support self-administered abortion in Poland are in fact delighted as they report that these doctors tend to charge very high fees and use outdated surgical abortion methods. Today, many Polish women turn to international organizations like Women help womenand Women on the Web, both based in the Netherlands, who have supplied abortion pills there for a decade.
Self-administered abortion with pills is a transformation for access to abortion in Poland. But because the pills can only be safely used on an outpatient basis in the first trimester, access to the pills is no substitute for safe, legal, and local care: self-administered abortion is not suitable for subsequent abortions when the risks medical conditions are increasing. People who have to end pregnancies with serious abnormalities will now be forced to travel abroad, mainly to England and the Netherlands, where abortion care is available for up to 24 and 22 weeks respectively.
The militant coalition Abortion Without Borders, launched last year, helps Poles get abortions in several countries, directing them to different member groups based on pregnancy, medical status and ability to travel. Protesters across Poland today paint Abortion Without Borders phone number on walls and even churches.
Polish courts overturned a fundamental part of its abortion law. This will not reduce the demand for abortion in Poland or deter women from taking clandestine measures to obtain it. Restrictive abortion laws simply increase the proportion of abortions that take place under secret and unsafe conditions.